The damaging myth that doctors hasten the deaths of organ donors.

Advice on how to make the world better.
March 11 2009 6:38 AM

You Can't Take Them With You

The damaging myth that doctors hasten the deaths of organ donors.

Do you have a real-life do-gooding dilemma? Please send it to ask.my.goodness@gmail.com, and Patty and Sandy will try to answer it.

Dear Patty and Sandy,

For years I've been debating becoming an organ donor. However, I resist because I keep hearing the rumor that people who have this designation on their driver's licenses receive less than full treatment by EMTs so that their organs can be harvested. Is this true? I would love to get this rumor dispelled if it is false.

Bob

Patty:

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Bob, your question made me pull out my new driver's license and make sure I reregistered on my last license renewal! (I did.) I'm happy to have a chance to encourage our readers to become  organ donors and dispel this myth, because being an organ donor is a wonderful way to have your last act be one that improves or even saves the life of another. The rumor is false: Emergency-room and trauma doctors are there to support you, the patient, and they are entirely focused on saving your life until they know it's not possible. This myth, and another nine organ donation myths outlined by the Mayo Clinic, is contributing to the gap between the more than 100,000 desperate folks on the waiting list and the 25,630 actual donations in the past year.

What will it take for donations to reach the level of need? We certainly don't need more deaths—there were more than 2.4 million deaths in the United States in 2005. We need more organ donors.

Kidney transplant operation. Click image to expand.
Do medical professionals harvest organ donors?

Three simple steps can help us get there. Every reader should follow them today. They will take you less than an hour: First, read the best information you can find for people considering organ donation. We recommend this brief fact sheet from the Journal of the American Medical Association. Second, complete or update your donor registration through an easy online registry like this one from the National Transplant Society (or via your driver's license renewal process). Third—this may be most important—share your decision with your loved ones, and ask for their cooperation in ensuring that your wishes are followed. While the law is different from state to state, your family may end up being asked to make the final decision regardless of whether you are a designated donor. No matter what local law dictates, it will certainly make it an easier decision for your loved ones to support if they are notified of your intentions now rather than later. Sharing your decision might inspire them to register, too. Most of the online registries we looked at have the option to send an e-mail notice to your family. (I sent two myself this morning: I think my family already knew of my intentions, but now they definitely do.) If you'd rather have a little bit more time to discuss, an after-dinner conversation tonight is a great idea, too.

It is estimated that fewer than 50 percent of registered donors' organs are harvested because their family members are concerned or uncooperative and ultimately decide not to consent to the donation. If that were to happen to you, it would mean your last great gift would go unfulfilled. You can prevent that—and perhaps even encourage other gifts to be made—by making sure your family understands and agrees to support your intentions.

Sandy:

I wish I could say this myth comes out of thin air, but unfortunately it doesn't. While my mom is right that both EMTs and doctors are bound by ethics and law to act in your best interest, recent changes in organ donation guidelines fueled concerns that a new practice known as donation after cardiac death may disturb the donor's family and increase uncertainty in the organ donation process. T he new guidelines allow for the donor's surrogate to consent to withdrawal of life support if total cardiac * death has been confirmed by multiple doctors, thus increasing the chance that the organs can be harvested in a short enough time to be successfully transplanted into a needy recipient.

The few highly publicized instances in which a patient's donor status appeared to negatively influence the medical team's treatment have surely served to kindle Bob's fears. In one recent case, a San Francisco transplant surgeon was charged with a felony for allegedly hastening a potential donor's death. (The patient was in a coma after suffering a serious heart attack.) The doctor was acquitted, but only after intense media scrutiny that may have caused potential donors to hold off on registering.

Both individual physicians and organ transplant organizations realize that this fear is one of the main reasons that Americans don't sign up to be donors. They are adamant that doctors and nurses always place the welfare of the patient first. Donation guidelines specifically address ways to ensure that a patient's donor status doesn't affect his or her care and require multiple checks to ensure that the donor is actually dead before the process is initiated. While this is clearly a decision you have to make for yourself, please don't let what could be your biggest gift get buried with you.

Do you have a real-life do-gooding dilemma? Please send it to ask.my.goodness@gmail.com and Patty and Sandy will try to answer it. In our ongoing effort to do better ourselves, we're donating 25 percent of the proceeds from this column to ONE.org—an organization committed to raising public awareness about the issues of global poverty, hunger, and disease and the efforts to fight such problems in the world's poorest countries.

C orrection, March 12, 2009: The article originally said that new guidelines allow withdrawal of life support after total brain death. In fact, the new guidelines allow withdrawal life support after total cardiac death. (Return to the corrected sentence.)

Patty Stonesifer is the chair of the Smithsonian Institution Board of Regents and a senior adviser to the Bill and Melinda Gates Foundation, where she was president, then CEO for 10 years. She spent the first two decades of her career in the technology business, where her last job was senior vice president at Microsoft.

Sandy Stonesifer works on issues related to adolescent girls' health at a nonprofit based in Washington, D.C.

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